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Cardiovascular System > Session 11- Haemodynamic shock > Flashcards

Session 11- Haemodynamic shock Flashcards

1
Q

How do yo calculate mean arterial blood pressure

A

CO x TPR

SV x HR x TPR

Diastolic pressure + 1/3 pulse pressure

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2
Q

What is haemodynamic shock

A

Acute condition of inadequate blood floe throughout the body

A catastrophic fall in arterial blood pressure leads to circulatory shock

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3
Q

What can cause shock

A

A fall in cardiac output

Fall in TPR beyond capacity of the heart to cope

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4
Q

How can a fall in CO cause shock

A

Fall in CO can be due to-

Mechanical- pump cannot fill

Loss of blood volume

Pump failure

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5
Q

What is cardiogenic shock

A

Acute failure of the heart to maintain cardiac output- pump failure

Heart fills but fails to pump

CVP raised because EDV is raised so EDP is raised to heart is harder to fill

Dramatic drop in arterial BP due to drop in CO

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6
Q

Causes of cardiogenic shock

A

Following myocardial infarction
-damage to left ventricle

Serious arrhythmia

Acute worsening of heart failure

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7
Q

Consequences of cardiogenic shock

A

Tissues portly perfused

  • coronary arteries may be poorly perfused which exacerbates problem
  • kidney may be poorly perfused- reduced urine production (oliguria)
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8
Q

What is cardiac arrest

A

Unresponsiveness associated with lack of pulse

Heart has stopped or has ceased to pump effectively

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9
Q

Types of cardiac arrest

A

Asystole

Ventricular fibrillation

Pulseless electrical activity

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10
Q

How do you treat cardiac arrest

A

Basic life support

Advanced life support

  • defibrillator
  • electrical current delivered to heart
  • depolarises al the cells- puls them into refractory period
  • allows coordinated electrical activity to restart

Adrenaline

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11
Q

What if mechanical shock- cardiac tamponade

A
  • Blood of fluid build up in pericardial space
  • restricts filling of the heart- limits end diastolic volume
  • affects both sides of heart

High CVP- heart harder to fill
Low arterial blood pressure- always low in shock

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12
Q

Mechanical shock - pulmonary embolism

A

Embolus occuldes large pulmonary artery

RV cant empty

CVP is high

Reduced return of blood to left heart - limited filling of left heart

Low arterial pressure- low SV

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13
Q

Symptoms pulmonary embolism

A

Chest pain

Dyspnoea

Difficulty breathing

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14
Q

How might an embolus reach the lungs

A

DVT

Portion of thrombus breaks off

Travels in venous system to right side of heart

Pumped out pulmonary artery to lungs

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15
Q

What is hypovolaemic shock

A

Reduced blood volume mostly due to haemorrhage

30-40% substantial decrease in mean aBP and serious shock response

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16
Q

What happens in haemorrhage

A

Venous pressure falls

Cardiac output falls

Arterial pressure falls

Detected by baroreceptors

17
Q

Compensatory resposne of hypovoloemic shock

A 
– increased sympathetic stimulation
– tachycardia
– increased force of contraction
– peripheral vasoconstriction
-venoconstriction
18
Q

Symptoms of hypovolaemic shock

A

Tachycardia

Weak pulse- decrease in Sv due to decrease in blood volume

Pale skin

Cold, clammy extremities

19
Q

What is decomposition

A

Peripheral vasoconstriction impairs tissue perfusion

  • release of vasodilators
  • TPR falls
  • blood pressure falls
  • vital organs can no longer be perfused
  • multi system failure
20
Q

What is distributive shock

A

Uncontrolled falls in peripheral resistance

Profound peripheral vasodilation- decrease in TPR therefore ABP

21
Q

What is toxic septic shock

A

Endotoxins released by circulating bacteria

  • profound inflammatory response
  • profound vasodilation
  • dramatic fall in TPR
  • fall in arterial pressure
  • impaired perfusion of vital organs
  • capillaries become leaky therefore blood volume is reduced
  • increased coagulation and localised hypo-perfusion in extremities
22
Q

Symptoms of septic shock

A

Tachycardia

Warm, red extremities initially but later stages of sepsis- vasoconstriction- localised hypoperfusion

23
Q

What is anaphylactic shock

A

Severe allergic reaction causes release of histamine from mast cells which has a powerful vasodilator effect which causes a fall in TPR

Drop in arterial pressure causes increased sympathies response- increase in CO but can’t overcome vasodilation

24
Q

Consequences of anaphylaxis

A

Impaired vital organ perfusion

Bronconstricipn and laryngeal oedema
-difficulty breathing

25
Q

Symptoms of anaphylactic shock

A

Difficulty breathing
Collapsed
Rapid hr
Red warm extremities

26
Q

Treatment of anaphylactic shock

A

Adrenaline in pharmacological dose - vasoconstriction at alpha 1 adrenoceptors in SMC

Cardiovascular System (18 decks)

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